Theories of Psychotherapy Series
The Basics of Psychotherapy: An Introduction to Theory and Practice
Bruce E. Wampold
Brief Dynamic Therapy
Hanna Levenson
Cognitive–Behavioral Therapy
Michelle G. Craske
Existential–Humanistic Therapy
Kirk J. Schneider and Orah T. Krug
Family Therapy
William J. Doherty and Susan H. McDaniel
Feminist Therapy
Laura S. Brown
Person-Centered Psychotherapies
David J. Cain
Psychotherapy Integration
George Stricker
Relational–Cultural Therapy
Judith V. Jordan
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Library of Congress Cataloging-in-Publication Data
Cain, David J.
Person-centered psychotherapies / David J. Cain. — 1st ed.
p.; cm. — (APA theories of psychotherapy series)
Includes bibliographical references and index.
ISBN-13:978-1-4338-0721-3
ISBN-10: 1-4338-0721-1
1. Client-centered psychotherapy. I. American Psychological Association. II. Title. III. Series: APA theories of psychotherapy series.
[DNLM: 1. Nondirective Therapy—methods. 2. Psychological Theory.
WM 420.5.N8 C135p 2010]
RC481.C28 2010
616.89'14—dc22
2009041275
British Library Cataloguing-in-Publication Data
A CIP record is available from the British Library.
Printed in the United States of America
First Edition
Contents
Series Preface
1. Introduction
2. History
3. Theory
4. The Therapy Process
5. Evaluation
6. Future Developments
Glossary of Key Terms
Suggested Readings
References
About the Author
Series Preface
Some might argue that in the contemporary clinical practice of psychotherapy, evidence-based intervention and effective outcome have overshadowed theory in importance. Maybe. But, as the editors of this series, we don’t propose to take up that controversy here. We do know that psychotherapists adopt and practice according to one theory or another because their experience, and decades of good evidence, suggests that having a sound theory of psychotherapy leads to greater therapeutic success. Still, the role of theory in the helping process can be hard to explain. This narrative about solving problems helps convey theory’s importance:
Aesop tells the fable of the sun and wind having a contest to decide who was the most powerful. From above the earth, they spotted a man walking down the street, and the wind said that he bet he could get his coat off. The sun agreed to the contest. The wind blew and the man held on tightly to his coat. The more the wind blew, the tighter he held. The sun said it was his turn. He put all of his energy into creating warm sunshine and soon the man took off his coat.
What does a competition between the sun and the wind to remove a man’s coat have to do with theories of psychotherapy? We think this deceptively simple story highlights the importance of theory as the precursor to any effective intervention—and hence to a favorable outcome. Without a guiding theory, we might treat the symptom without understanding the role of the individual. Or we might create power conflicts with our clients and not understand that, at times, indirect means of helping (sunshine) are often as effective—if not more so—than direct ones (wind). In the absence of theory, we might lose track of the treatment rationale and instead get caught up in, for example, social correctness and not wanting to do something that looks too simple.
What exactly is theory? The APA Dictionary of Psychology defines theory as “a principle or body of interrelated principles that purports to explain or predict a number of interrelated phenomena” In psychotherapy, a theory is a set of principles used to explain human thought and behavior, including what causes people to change. In practice, a theory creates the goals of therapy and specifies how to pursue them. Haley (1997) noted that a theory of psychotherapy ought to be simple enough for the average therapist to understand, but comprehensive enough to account for a wide range of eventualities. Furthermore, a theory guides action toward successful outcomes while generating hope in both the therapist and client that recovery is possible.
Theory is the compass that allows psychotherapists to navigate the vast territory of clinical practice. In the same ways that navigational tools have been modified to adapt to advances in thinking and ever-expanding territories to explore, theories of psychotherapy have changed over time. The different schools of theories are commonly referred to as waves, the first wave being psychodynamic theories (i.e., Adlerian, psychoanalytic), the second wave learning theories (i.e., behavioral, cognitive–behavioral), the third wave humanistic theories (person-centered, gestalt, existential), the fourth wave feminist and multicultural theories, and the fifth wave postmodern and constructivist theories. In many ways, these waves represent how psychotherapy has adapted and responded to changes in psychology, society, and epistemology as well as to changes in the nature of psychotherapy itself. Psychotherapy and the theories that guide it are dynamic and responsive. The wide variety of theories is also testament to the different ways in which the same human behavior can be conceptualized (Frew & Spiegler, 2008).
It is with these two concepts in mind—the central importance of theory and the natural evolution of theoretical thinking—that we developed the APA Theories of Psychotherapy Series. Both of us are thoroughly fascinated by theory and the range of complex ideas that drive each model. As university faculty members who teach courses on the theories of psychotherapy, we wanted to create learning materials that not only highlight the essence of the major theories for professionals and professionals in training but also clearly bring the reader up to date on the current status of the models. Often in books on theory, the biography of the original theorist overshadows the evolution of the model. In contrast, our intent is to highlight the contemporary uses of the theories as well as their history and context.
As this project began, we faced two immediate decisions: which theories to address and who best to present them. We looked at graduate-level theories of psychotherapy courses to see which theories are being taught, and we explored popular scholarly books, articles, and conferences to determine which theories draw the most interest. We then developed a dream list of authors from among the best minds in contemporary theoretical practice. Each author is one of the leading proponents of that approach as well as a knowledgeable practitioner. We asked each author to review the core constructs of the theory, bring the theory into the modern sphere of clinical practice by looking at it through a context of evidence-based practice, and clearly illustrate how the theory looks in action.
There are 24 titles planned for the series. Each title can stand alone or can be put together with a few other titles to create materials for a course in psychotherapy theories. This option allows instructors to create a course featuring the approaches they believe are the most salient today. To support this end, APA Books has also developed a DVD for each of the approaches that demonstrates the theory in practice with a real client. Many of the DVDs show therapy over six sessions. Contact APA Books for a complete list of available DVD programs (http://www.apa.org/videos).
Person-centered psychotherapy was the first truly American theory of psychotherapy, and as such created a monumental change in the actual practice of psychotherapy. As one of the most influential and revered psychologists, Carl Rogers developed this model rooted in principles of democracy and humanism, believing that people were best served when they were helped to find their own best way. Though Carl Rogers is synonymous with the person-centered approach, the theory has evolved over time in response to changes in the field. In Person-Centered Psychotherapies, Dr. David J. Cain clearly presents the evolution and essential components of this core approach to contemporary clinical practice. He highlights the extensive clinical research supporting the efficacy of person-centered practice and provides illustrative case examples that depict this model in action. Because of the widespread adoption of this model by practitioners and training programs alike, Person-Centered Psychotherapies is an important addition to the series.
—Jon Carlson and Matt Englar-Carlson
REFERENCES
Frew, J., & Spiegler, M. (2008). Contemporary psychotherapies for a diverse world. Boston, MA: Lahaska Press.
Haley, J. (1997). Leaving home: The therapy of disturbed young people. New York, NY: Routledge.
Introduction
Carl Rogers’s seminal ideas have had a pervasive, profound, and revolutionary effect on how psychotherapy has been conceived and practiced for the last 70 years. In a survey of clinical and counseling psychologists published in 1982 in American Psychologist (Smith, 1982), Rogers (1902–1987) was identified as the most influential psychotherapist. Twenty-five years later, in a much larger survey of psychotherapists conducted by The Psychotherapy Networker (“The Top 10,” 2007), Rogers was again identified as the “most influential therapist” despite the fact that relatively few persons in the United States identify themselves as person-centered therapists. His foundational ideas, especially the significance of the therapeutic relationship as a means to growth, have been absorbed by many diverse approaches to psychotherapy. Person-centered therapy is based on the assumption that all humans have an innate tendency to actualize their potential to grow psychologically and to manage their lives effectively if provided a therapeutic relationship characterized by specific therapist qualities or conditions. This optimistic view of the client’s potential for growth stood in stark contrast to Freud’s darker view of the human psyche. Person-centered therapists believe that if their clients perceive that their therapists (a) understand who they are and how they perceive the world (empathic understanding), (b) accept them without judgment (unconditional positive regard), and (c) are genuine in the therapeutic relationship (congruence), then constructive therapeutic change is likely to take place. The fundamental endeavor of person-centered therapists is to establish these relational conditions for their clients.
The name given to the therapy that Rogers developed evolved over time. Initially his approach was called non-directive psychotherapy during the early to mid-1940s, emphasizing Rogers’s belief that clients rather than therapists should determine the direction of therapy and that clients’ autonomy in deciding how to live their lives should be respected and preserved. Person-centered therapists believe that optimal change and growth occurs when it is self-directed, as opposed to therapist-directed. Thus, clients determine the content of therapy, what directions they want their life to take and the means of achieving desired changes.
By the mid-1940s, Rogers called his approach client-centered therapy, a designation that persisted until the 1970s when he began to use the term person-centered therapy. Today person-centered therapy is most commonly used and is essentially synonymous with client-centered therapy. I will primarily use the term person-centered therapy throughout the text unless the earlier term client-centered therapy is relevant in a historical context.
Rogers’s influence on American psychotherapy is enormous, though often indirect. More than any other therapist, Carl Rogers taught us to listen with sensitivity and to communicate that understanding to the client for further processing and personal learning. This desire to hear another person as he or she shares something of personal relevance is at the heart of all good therapy and caring relationships. All persons have a powerful and near-universal need to be heard, seen, accepted, and appreciated as they are, including their flaws and limitations. Conversely, clients often feel frustrated, discouraged, and alienated when misunderstood or judged by their therapists and others who matter to them. People are naturally drawn to those who listen with compassion and acceptance. Whether they are therapists, teachers, parents, family members, coaches, employers, leaders, friends, or others of personal importance, such confidants are critical to a person’s well-being.
Rogers demonstrated that the quality of the therapist–client relationship, in itself, has the potential to foster personal learning and growth in the client. Many of our clients come to us with low self-esteem and interpersonal insecurities that have developed in damaging relationships with their parents, partners, and significant others. Such clients often need and benefit from a relationship in which their therapists’ regard and valuing is unconditional. In order to repair their feelings of low self-worth, even self-loathing, clients often benefit from the prizing and affirmation of their therapists that assists them in revising their self-views in more accepting and positive directions. There are times when the quality and depth of contact itself seem to enable clients to experience themselves in new and, sometimes, transformative ways. Many persons have had powerful experiences with others who have made constructive and lasting impacts on their lives. Such experiences are often possible in moments of therapy during which there is a genuine meeting between therapist and client.
In addition to affirming the client, the quality of the therapist–client relationship almost always plays a critical role in the process of therapeutic learning. Clients are most likely to learn with and from therapists they value, like, trust, and perceive as having their best interests at heart. Conversely, clients’ therapeutic progress is often impaired when they have negative or ambivalent feelings toward their therapists. Thus, a solid therapeutic relationship serves as the foundation upon which constructive learning takes place.
Rogers was a pioneer whose ground breaking insights and discoveries continue to have far-reaching effects on the field of psychotherapy. Rogers and his students were the first to study the counseling process in depth. In 1940, with the assistance of Bernie Covner, the first audio readings of a therapy session were made on 78-rpm recordings. These “live” and transcribed recordings provided moment-to-moment understandings of the therapeutic process and its immediate effects on the client as well as case studies for training and research. The case of Herbert Bryan (Rogers, 1942) was the first phonographically recorded verbatim transcript of an entire course of psychotherapy ever published. Although today we take for granted the usefulness of reviewing audio and video recordings for training purposes, Rogers was the first to demystify psychotherapy by bringing it out into the open for study Rogers was also a pioneer in carrying out and publishing psychotherapy research studies and was primarily responsible for initiating research in the field of psychotherapy. In 1957 he articulated a bold hypothesis regarding the “Necessary and Sufficient Conditions of Therapeutic Personality Change.” This simple and elegant statement has probably generated more research than any other therapeutic hypothesis in the field. The research tradition established by Rogers and his students has carried forward to the present to ensure the continued development and efficacy of client-centered therapy. In 1959, Rogers published his magnum opus, “A Theory of Therapy, Personality, and Interpersonal Relationships,” which remains as the most formal statement of person-centered theory. However, Rogers’s theory has not remained static as many person-centered scholars and practitioners have continued to expand and modify this seminal approach. Rogers himself always supported and encouraged continuing developments in theory and practice and firmly believed that his approach should continue to evolve. Today, there is no longer one version of person-centered therapy but a number of continuously evolving approaches to therapy.
Rogers has been characterized as a quiet revolutionary because his ideas issued a fundamental challenge to other therapeutic approaches, especially those embracing a medical model that views the therapist’s role as primary in diagnosing the client’s problem and deciding on an appropriate course of therapy to treat a specific form of psychopathology. Rogers’s use of the term client instead of patient conveys his belief that persons in therapy are capable and resourceful, not sick, helpless, or in need of guidance. Psychopathology or problems in living were understood as the client’s ineffective attempt to cope with problems as opposed to a defect or deficiency. As is suggested by the descriptors “nondirective” and “client-centered,” Rogers placed the client at the center of the change process and relied on the client’s resources and potential for constructive change. The therapist’s role was one of freeing clients to explore themselves and their lived experiences and to help them release or realize their inherent tendency for growth. Rogers’s radical views continue to serve as a challenge and alternate view of how psychotherapy is conceived and practiced.
An enormous body of research conducted over a period of 70 years supports the effectiveness of person-centered psychotherapies. This research is ongoing and continues to generate new hypotheses and assess various aspects of person-centered psychotherapies, resulting in an increasingly expanded and refined understanding of the effective processes of therapy. It includes both quantitative and qualitative methods designed to understand the inner experiences of therapist and client as well as the effectiveness of person-centered therapy with a number of specific forms of psychopathology.
Person-centered psychotherapies are thriving all over the world. Kirschenbaum and Jourdan (2005) reported that between 1987 and 2004, a total of 777 person-centered publications, including 141 books, were published. This total far exceeds all of the previous publications over a 40-year period from 1946 to 1986. Further, there are approximately 200 person-centered organizations and training centers worldwide. In most graduate programs in psychology and counseling, students are trained in empathic responding and relational skills as a foundation for most therapeutic approaches. Recent years have seen many developments in theory and refinements in practice, thereby broadening the effectiveness of person-centered therapy. Clearly, the person-centered approach is alive and well and continues to have an enormous impact on the practice of many, if not most, therapists. In sum, person-centered therapy is as vital and relevant as it has ever been and continues to develop in ways that will make it increasingly so in the years to come. Finally, in a time when the world seems increasingly dehumanized by many forces, the humanizing message and effects of person-centered therapies are sorely needed.
History
The roots of client-centered therapy reach back to the late 1920s when Carl Rogers spent his formative years as a clinical psychologist in Rochester, New York. Rogers was a pragmatist in practice. As he found himself faced with large numbers of troubled children and parents, his guiding questions were “Does it work?” and “Is it effective?”
Rogers’s approach to his clinical work was based on careful systematic observation as opposed to trial and error. Not content to rely on subjective impressions, he carefully evaluated the effects of his work. This would become a lifetime endeavor and strong value.
During his Rochester years (1928–1939), Rogers came to believe that “most children, if given a reasonably normal environment which meets their own emotional, intellectual and social needs, have within themselves sufficient drive toward health to respond and make a comfortable adjustment to life” (Kirschenbaum, 1979, p. 75). An important belief emerging in Rogers’s practice was the notion that individual growth was more likely to occur in a certain kind of interpersonal environment.
While he experimented with a number of treatment approaches, including psychoanalytic, Rogers came to find each one lacking in some way. Ever a pragmatist, he abandoned any approach that did not seem effective. After several years of experience working with troubled children and their parents, Rogers began to realize that he was “moving away from any approach which was coercive or strongly interpretative, not for philosophical reasons, but because such approaches were never more than superficially effective” (Burton, 1972, pp. 47–48).
Around 1936, Rogers became interested in Otto Rank’s work and invited Rank to Rochester for a weekend seminar, which Rogers described as “very profitable.” About the Rankian approach Rogers recalled, “its major value may be . . . the fresh viewpoint of non-interference and reliance on the individual’s own tendency toward growth” (Kirschenbaum, 1979, p. 93). Rogers was also drawn to Rank’s emphasis on the therapist’s supportive and acceptant stance toward the client and the value placed on client self-insight. Rogers embraced four specific elements of Rank’s relational therapy: (a) the importance of the quality of relationship between therapist and client, (b) the therapist’s endeavor to provide an atmosphere that enables clients to “experience and realize” their own attitudes, (c) the therapist’s acceptance of the client and a disinclination to impose recommendations or viewpoints on clients, and (d) an emphasis on clarification of the client’s feelings and acceptance of the client.
Toward the end of his Rochester years, Rogers identified in his first book, The Clinical Treatment of the Problem Child (1939), some of the basic elements that would form the foundation for what would be later known as client-centered therapy. These elements consisted of a sympathetic understanding, respect for the individual, and an understanding of the self of the client.
OHIO STATE UNIVERSITY (1939–1945)
Rogers left Rochester and took a position at Ohio State University in 1939 as a full professor in the psychology department. In addition to teaching a full load of courses, he supervised counseling students, wrote several articles, and counseled several students. Rogers established a practicum in counseling and psychotherapy in 1940 for graduate trainees that was likely the first such supervised training offered in a university setting.
While at Ohio State, Rogers wrote Counseling and Psychotherapy: Newer Concepts in Practice (1942), a classic textbook on basic therapeutic issues, methods, the therapy relationship, and the process of change. The descriptive terms non-directive and client were introduced to underscore the therapist’s belief that the direction and locus of control in therapy were clearly centered in the person seeking help. This was a radical shift away from the interpretive and directive methods that were commonly employed at the time. As Seeman perceptively stated, “The enduring process which Rogers set in motion in 1942 was a reexamination of the nature of therapy . . . which continues to this day” (Wolman, 1965, p. 1215).
Rogers and his students were the first to study the counseling process in depth, assisted in large part by audio recordings of therapy sessions. These “live” and transcribed recordings proved invaluable as resources for both training and research. Finally, Rogers was a pioneer in carrying out and publishing research studies in counseling. Early in Counseling and Psychotherapy, Rogers stated that the book “endeavors to formulate a definite and understandable series of hypotheses . . . which may be tested and explored” (pp. 16–17). The research tradition established by Rogers and his students during this period has carried forward to the present to ensure the continued development and efficacy of person-centered therapy.
UNIVERSITY OF CHICAGO (1945–1957)
In 1945 Rogers left Ohio State to create and direct the Counseling Center at the University of Chicago. There he continued to develop client-centered theory and practice while conducting research on its effectiveness. Rogers said about his Chicago years that this was “a period in which our basic views about the helping relationship came to fruition. . . . It was a germinal period for research hypotheses and theoretical formulations” (Burton, 1972, p. 54).
In 1951, Rogers’s third major book, Client-Centered Therapy, was published. Applications of the client-centered approach to play therapy, group therapy, leadership and administration, teaching, and counselor training were advanced. In this period, Rogers further emphasized the attitudes of the therapist as primary over technique, as well as the capacity of the client for constructive change. Rogers focused on creating a relationship that would release the client’s natural tendency for actualization and growth. Increasing emphasis was placed on understanding the client’s phenomenal world and its meaning.
Between 1943 and 1957, approximately 200 studies were conducted on client-centered therapy and its applications to children, groups, education, industry, and leadership. In 1954, the results of a group of studies, co-edited by Rogers and Rosalind Dymond, were published in Psychotherapy and Personality Change. The studies that Rogers referred to as a “pioneering venture” were moderately supportive of client-centered hypotheses.
Rogers received considerable credit and praise for the research efforts he stimulated at the Counseling Center. Joseph Matarrazzo placed Rogers’s research efforts in perspective in 1965 when he wrote: “His approach to the interview stimulated research more than the works of any single writer on the interview before or since”; Matarrazzo went on to state that Psychotherapy and Personality Change was “probably the single most important research publication on interviewing (as found in psychotherapy) of the decade” (Kirschenbaum, 1979, p. 219). Based primarily on his research contributions in psychotherapy, Rogers, along with Kenneth W. Spence and Wolfgang Kohler, was awarded the first Distinguished Scientific Contribution Award presented by the American Psychological Association in 1956.
In 1957, Rogers published his formulation of what he would call “The Necessary and Sufficient Conditions of Therapeutic Personality Change.” This formulation represented the culmination of many years of development in his thinking.
UNIVERSITY OF WISCONSIN (1957–1963)
In the spring of 1957, Rogers accepted a position at the University of Wisconsin, much to the chagrin of the University of Chicago Counseling Center staff who were stunned by his sudden decision to leave. Rogers and his colleagues were curious to see if his hypothesis about the necessary and sufficient conditions of personality change applied to seriously disturbed persons. In 1957 he began to develop an ambitious research project on the treatment of persons suffering from schizophrenia. The results of the study showed no significant differences between the therapy group and the control group, although there was a correlation between high levels of the therapist conditions of congruence and empathy and successful outcome. While much was learned about psychotherapy with schizophrenic persons, the research evidence for client-centered therapy was modest.
In 1959, Rogers published “A Theory of Therapy, Personality and Interpersonal Relationships” in Sigmund Koch’s Psychology: A Study of a Science. This 72-page formal statement of his theory continues to stand as the most complete articulation of Rogers’s position. Rogers’s fifth major book, On Becoming a Person, was published in 1961. It contains many of his best-known and most influential papers. Some of his most provocative and incisive thinking on psychotherapy, education research, philosophy of science, interpersonal relations, family life, creativity, the process of growth, and the fully functioning person are contained in this book. Soon after its publication, there was an enormous outpouring of touching and appreciative responses from professionals and laypersons from every walk of life. Rogers’s humane and provocative message had clearly struck a chord.
LA JOLLA AND CENTER FOR STUDIES OF THE PERSON (1964–1987)
In the summer of 1963, Rogers resigned from the University of Wisconsin and moved to California, in part because of the harsh way he felt graduate students were being treated. For several years, starting in 1964, Rogers involved himself in the encounter group movement and became a national leader in the field. The magazine Psychology Today identified him as a “grand master” while Look magazine referred to him as “an elder statesman of encounter groups.” In 1970, Rogers completed Carl Rogers on Encounter Groups, which clearly associated him with encounter groups among both professionals and the general public. In 1972, Rogers received the first Distinguished Professional Contribution Award from the American Psychological Association.
During the 1970s, a modest approach to family therapy was presented by Raskin and van der Veen, while Tom Gordon was developing a program for parent effectiveness training (P.E.T), which would eventually impact millions of parents and children worldwide. In sum, the 1960s and 1970s were a fertile period of development in the theory and practice of therapy and the expansion of client-centered concepts into diverse areas of application.
In the last 15 or so years of his life, Rogers became increasingly interested in broader social issues, especially peace. Beginning in 1974, Carl and his daughter, Natalie Rogers, along with several of their colleagues, initiated a series of large group workshops, sometimes 2 or 3 weeks in length, to explore the implications of the person-centered approach for building optimal communities in groups ranging from 75 to 800 persons. For the first time, Rogers would use the phrase person-centered to describe these workshops, which would be offered all over the world for the next several years. As those workshops evolved, Rogers and the staff of facilitators provided less and less structure, instead leaving most, if not all, of the decision making to the entire community. Such large community groups are rarely part of person-centered practice today. Their demise was primarily because they were often frustrating and contentious and had relatively little demonstrated therapeutic value.
A Way of Being was published in 1980. It is a diverse collection of papers representing the evolution of Rogers’s thought in the 1970s. Many of the papers were very personal statements of Rogers’ growth and changing views.
In 1986 the quarterly academic journal Person-Centered Review began publication under the editorship of this author. Up to this point Rogers had discouraged the creation of client-centered training programs, organizations, or journals, fearing that his approach would become formalized and dogmatic. By 1986, however, Rogers supported and welcomed the journal and wrote in its first issue that it “will help to tie together the global network that already exists but lacks awareness of itself. The Review can be a vehicle for new ideas, innovative methods, thoughtful critiques, new models of research, and integrative philosophical and theoretical thinking” (Rogers, 1986, p. 5).
Unfortunately, Carl Rogers was not able to pursue further the strongest commitments of his last years—to contribute whatever he could to the prevention of nuclear war and the achievement of world peace. On January 20, 1987, on the day when Rogers fell and broke his hip and required hospitalization, he was nominated, at age 85, by Congressman Jim Bates for the 1987 Nobel Peace Prize. A few weeks later, on February 4, 1987, Rogers died as he had hoped he would—with his boots on and, as always, looking forward. He had been relatively healthy and active until his death.
From the time of Rogers’s death, there has been a substantial amount of progress in the theory and practice in person-centered theory. In the next chapter, I will review Rogers’s basic theory as well as recent developments.
Theory
Carl Rogers published the most complete statement of his approach in 1959 and never modified it in any significant way. However, Rogers never considered his theory to be a finished product and anticipated that it would be developed further over time. The most essential concepts of his approach will be identified in this section, followed by variations of person-centered therapy and substantive contemporary developments
THERAPEUTIC GOALS
The goals of the person-centered therapist are primarily process goals. Therefore, the quality of engagement, moment to moment, between therapist and client is central. The fundamental goal of person-centered therapists is the creation of an optimal therapeutic relationship for their clients. As Rogers has eloquently stated: “Individuals have within themselves vast resources for self-understanding, and for altering their self-concepts, basic attitudes, and self-directed behavior; these resources can be tapped if a definable climate of facilitative psychological attitudes can be provided” (1980, p. 115). The “definable climate” includes (a) the therapist’s congruence, genuineness, authenticity, or transparency; (b) unconditional positive regard or nonpossessive warmth, acceptance, nonjudgmental caring, liking, prizing, affirmation; and (c) a genuine desire to understand the client’s experience and accurate empathic communication of that experience. Toward the end of his life, Rogers also identified therapist presence as a powerful and facilitative aspect of the person-centered therapist’s manner of being. Rogers (1957) assumed that if the client experienced these therapist qualities or conditions, personal growth would take place.
While Rogers and other person-centered therapists were concerned with clients’ achievement of their goals, the emphasis of the therapist is on creating conditions for growth rather than alleviation of symptoms alone. In other words, the emphasis is on the development of the whole person rather than on a specific complaint. For some person-centered therapists, the only goal is to provide the core conditions while other person-centered therapists believe that the identification of and focus on specific client-generated goals is desirable because it gives the therapy direction and cohesion and assures that the therapist and client are working toward the client’s ends.
KEY CONCEPTS